UNASSIGNED: Revision hip and knee total joint arthroplasty (TJA) carries a high burden of postoperative complications, including surgical site infections (SSI), venous thromboembolism (VTE), reoperation, and readmission, which negatively affect postoperative outcomes and patient satisfaction. Socioeconomic area-level composite indices such as the area deprivation index (ADI) are increasingly important measures of social determinants of health (SDoH). This study aims to determine the potential association between ADI and SSI, VTE, reoperation, and readmission occurrence 90 days following revision TJA.
UNASSIGNED: 1047 consecutive revision TJA patients were retrospectively reviewed. Complications, including SSI, VTE, reoperation, and readmission, were combined into one dependent variable. ADI rankings were extracted using residential zip codes and categorized into quartiles. Univariate and multivariate logistic regressions were performed to analyze the association of ADI as an independent factor for complication following revision TJA.
UNASSIGNED: Depression (p = 0.034) and high ASA score (p < 0.001) were associated with higher odds of a combined complication postoperatively on univariate logistic regression. ADI was not associated with the occurrence of any of the complications recorded following surgery (p = 0.092). ASA remained an independent risk factor for developing postoperative complications on multivariate analysis.
UNASSIGNED: An ASA score of 3 or higher was significantly associated with higher odds of developing postoperative complications. Our findings suggest that ADI alone may not be a sufficient tool for predicting postoperative outcomes following revision TJA, and other area-level indices should be further investigated as potential markers of social determinants of health.

BACKGROUND: Chief Executive Officer\'s (CEO) are integral leaders of health care organisation. Over the last two decades in United States (US) hospitals, it has been noted that CEO turnover rates are increasing, and it was reported that the CEO turnover rates have augmented from 14% in 2008 to 18% in 2017 in the private sector. In Australia, it was discovered that during two years, 41 executives had 18 distinct positions. It has been highlighted that the increasing CEO turnover is a major issue for Australian and international health care organisations. Some of the negative consequences of CEO turnover include organisational instability, high financial costs, loss of human capital and adverse effects on staff morale and patient care.
OBJECTIVE: Our scoping review aimed to map and summarise the evidence associated with CEO turnovers in both health and non-health setting, and answer the following questions: 1. What are the reasons for CEO departure?, 2. What are the strategies to minimise CEO turnover?
RESULTS: A protocol explaining the objectives, inclusion criteria and methods for this scoping review were specified in advance and published. This scoping review included 17 studies (13 health and 4 non-health setting) published over a 31-year period that investigated and described the increasing CEO turnover rates. All 17 studies identified causes of CEO turnover along with certain studies identifying facilitators of CEO retention. We classified CEO\'s departure reasons into three major themes: organizational, performance, and personal. Organisational factors include CEO departures due to issues within the organisation, performance factors include issues with CEO\'s work and personal factors captures personal reasons for CEO\'s leaving their job.
CONCLUSIONS: CEOs are under immense pressure to deliver good results and drive growth while satisfying the interests of internal and external stakeholders. There are various reasons for CEO\'s departure however the most common factor identified is organisational.

BACKGROUND: Besides return to work (RTW) and return to sports (RTS), patients also prefer to return to daily activities (RTA) such as walking, sleeping, grocery shopping, and domestic work following total knee arthroplasty (TKA). However, evidence on the timelines and probability of patients\' RTA is sparse.
OBJECTIVE: To assess the percentage of patients able to RTA, RTW, and RTS after TKA, as well as the timeframe and influencing factors of this return.
METHODS: A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital. Assessments of RTA, RTW, and RTS were performed at 3 mo and/or 6 mo following TKA. Investigated factors encompassed patient characteristics, surgical characteristics, and preoperative patient-reported outcomes.
RESULTS: TKA patients [n = 2063; 66 years old (interquartile range [IQR]: 7 years); 47% male; 28 kg/m2 (IQR: 4 kg/m2)] showed RTA ranging from 28% for kneeling to 94% for grocery shopping, with 20 d (IQR: 27 d) spent for putting on shoes to 74 d (IQR: 57 d) for kneeling. RTW rates varied from 62% for medium-impact work to 87% for low-impact work, taking 33 d (IQR: 29 d) to 78 d (IQR: 55 d). RTS ranged from 48% for medium-impact sports to 90% for low-impact sports, occurring within 43 d (IQR: 24 d) to 90 d (IQR: 60 d). One or more of the investigated factors influenced the return to each of the 14 activities examined, with R² values ranging from 0.013 to 0.127.
CONCLUSIONS: Approximately 80% of patients can RTA, RTW, and RTS within 6 mo after TKA. Return is not consistently influenced by predictive factors. Results help set realistic pre- and postoperative expectations.

We report two cases wherein rotating hinge knee (RHK) arthroplasty was performed for Charcot joints that developed secondary to Charcot-Marie-Tooth disease (CMT).  Case 1 was of a 74-year-old woman with CMT. She presented with muscle weakness and sensory disturbances of the distal lower limbs, deformity, and significant medial instability of the bilateral knees. She was then diagnosed with Charcot joints of the knees secondary to CMT, which were treated with RHK arthroplasty. Five years postoperatively, there was no instability, and she was able to stand unassisted without pain. Case 2 was a 90-year-old woman with CMT who presented with muscle weakness and sensory disturbances of the distal lower limbs, deformity, and significant medial instability of the bilateral knees. She was then diagnosed with Charcot joints of the knees secondary to CMT, which were also treated with RHK arthroplasty. One year postoperatively, there was no instability, and she was able to walk smoothly using a walker. These clinical cases indicate that RHK arthroplasty can be a good therapeutic option for Charcot joints of the knees in patients with CMT.

UNASSIGNED: Cervical cancer is one of the most common gynecological malignancies worldwide. The incidence of cervical cancer ranks second for female malignancies in China. However, human papillomavirus (HPV) prevalence and genotype replacement for a long time in Beijing were not yet evaluated.
UNASSIGNED: Women patients who visited clinical departments, especially the gynecology department, were included in this study from 2014 to 2020. They suffered from different kinds of cervical abnormalities even cervical cancer. Thirteen types of HPV were detected in cervical samples by using multiple fluorescence polymerase chain reactions. All patients were divided into four groups according to age (15-30, 31-45, 46-60, and >60 years old).
UNASSIGNED: The study included data from four certain years (2014, 2016, 2018, and 2020). Overall HPV prevalence was 18.0%, 16.7%, 21.9%, and 19.1%, respectively. Of the 13 genotypes, the top one infection type was HPV52, followed by HPV58 and HPV16 or HPV16 and HPV58 in different years. HPV56 prevalence raised from 2018, which replaced HPV39 into the top five list. Only HPV prevalence of 46-60 years age group declined, mainly resulting from the reduced prevalence of HPV39 and HPV58 (p < 0.001 and p = 0.020). The proportions of HPV dual-infection across the four years varied significantly in statistics (p = 0.001), whereas the most common dual-infection HPV39/68 disappeared after 2018.
UNASSIGNED: The prevalence of two HPV genotypes (HPV39 and HPV58) and dual-infection HPV39/68 showed a declining trend, especially in the 46-60 years age group. The trends need to be observed continuously.

Microglia are resident immune cells in the central nervous system (CNS) that play vital roles in CNS development, homeostasis and disease pathogenesis. Genetic defects in microglia lead to microglial dysfunction, which in turn leads to neurological disorders. The correction of the specific genetic defects in microglia in these disorders can lead to therapeutic effects. Traditional genetic defect correction approaches are dependent on viral vector-based genetic defect corrections. However, the viruses used in these approaches, including adeno-associated viruses, lentiviruses and retroviruses, do not primarily target microglia; therefore, viral vector-based genetic defect corrections are ineffective in microglia. Microglia replacement is a novel approach to correct microglial genetic defects via replacing microglia of genetic defects with allogenic healthy microglia. In this paper, we systematically review the history, rationale and therapeutic perspectives of microglia replacement, which would be a novel strategy for treating CNS disorders.

UNASSIGNED: Severe acetabular bone defects can pose challenges in revision total hip replacement. The use of structural allografts and various sizes of grain allografts has been proposed as an alternative surgical technique for treating Paprosky type 3 acetabular defects. This study aimed to evaluate the long-term outcomes and potential complications associated with this approach.
UNASSIGNED: A retrospective review was performed on 102 hip reconstructions in patients with major acetabular bone loss, including 81 cases of type 3A and 21 cases of type 3B according to Paprosky\'s classification. Surgical procedures involved the use of structural allografts and various sizes of grain allografts in both reinforcement ring group and cementless cups group.
UNASSIGNED: At a mean follow-up of 82.75 months, 76% of hips had no complications, while The others experienced pain changes in the cup position, post-operative dislocations, and infections. The mean pre-operative Modified Harris Hip Score improved in both groups at the last follow-up.
UNASSIGNED: The use of structural allografts and various sizes of grain allografts for treating type 3 acetabular defects in revision total hip replacement showed promising long-term outcomes and a low rate of complications. Level of Evidence IV; Retrospective Case Series.
UNASSIGNED: Defeitos ósseos acetabulares graves podem representar desafios na revisão da artroplastia total do quadril. O uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos foram propostos como uma técnica cirúrgica alternativa para o tratamento de defeitos acetabulares Paprosky tipo 3. O objetivo deste estudo foi avaliar os resultados de longo prazo e as possíveis complicações associadas a essa abordagem.
UNASSIGNED: Foi realizada uma revisão retrospectiva de 102 reconstruções de quadril em pacientes com grande perda óssea acetabular, incluindo 81 casos do tipo 3A e 21 casos do tipo 3B de acordo com a classificação de Paprosky. Os procedimentos cirúrgicos envolveram o uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos, tanto no grupo do anel de reforço quanto no grupo das próteses sem cimento.
UNASSIGNED: Em um acompanhamento médio de 82,75 meses, 76% dos quadris não apresentaram complicações, enquanto os demais apresentaram dor, alterações na posição da prótese, luxações pós-operatórias e infecções. A pontuação média pré-operatória do escore de quadril modificado de Harris melhorou em ambos os grupos no último acompanhamento.
UNASSIGNED: O uso de aloenxertos estruturais e aloenxertos de grãos de vários tamanhos para o tratamento de defeitos acetabulares do tipo 3 na substituição total do quadril de revisão mostrou resultados promissores em longo prazo e uma baixa taxa de complicações. Nível de Evidência IV; Série de Casos Retrospectivos.

(1) Background: At present, the only potency assay approved in China for the in-country testing of botulinum toxin type A for injection products is the mouse bioassay (MBA). The Chinese market for neurotoxin products is rapidly expanding, but MBAs are subject to high variability due to individual variations in mice, as well as variations in injection sites, in addition to the limited number of batches tested for one MBA. Compared with the mLD50 method, the cell-based potency assay (CBPA) developed for the potency testing of onabotulinumtoxinA (BOTOX) by AbbVie not only does not use any experimental animals but also allows for significant time and cost savings. Due to the significant benefits conferred by the replacement of the mLD50 assay with CBPA in China, the CBPA method has been transferred, validated, and cross-validated to demonstrate the equivalence of the two potency methods. (2) Methods: The differentiated SiMa cells were treated with both BOTOX samples and the reference standard, and the cleaved SNAP25197 in the cell lysates was quantified using Chemi-ECL ELISA. A 4-PL model was used for the data fit and sample relative potency calculation. The method accuracy, linearity, repeatability, and intermediate precision were determined within the range of 50% to 200% of the labeled claim. A statistical equivalence of the two potency methods (CBPA and mLD50) was initially demonstrated by comparing the AbbVie CBPA data with NIFDC mLD50 data on a total of 167 commercial BOTOX lots (85 50U lots and 82 100U lots). In addition, six lots of onabotulinumtoxinA (three 50U and three 100U) were re-tested as cross-validation by these two methods for equivalence. (3) Results: The overall assay\'s accuracy and intermediate precision were determined as 104% and 9.2%, and the slope, R-square, and Y-intercept for linearity were determined as 1.071, 0.998, and 0.036, respectively. The repeatability was determined as 6.9%. The range with the acceptable criteria of accuracy, linearity, and precision was demonstrated as 50% to 200% of the labeled claim. The 95% equivalence statistic test using margins [80%, 125%] indicates that CBPA and mLD50 methods are equivalent for both BOTOX strengths (i.e., 50U and 100U). The relative potency data from cross-validation were within the range of ≥80% to ≤120%. (4) Conclusions: The CBPA meets all acceptance criteria and is equivalent to mLD50. The replacement of mLD50 with CBPA is well justified in terms of ensuring safety and efficacy, as well as for animal benefits.

Assistance during calving and cesarean section (C-section) are important risk factors for the failure of transfer of passive immunity (FTPI) in beef calves, which increases the risk of morbidity and mortality in beef calves during the preweaning period. Colostrum replacement recommendations for beef calves, and especially for those delivered by C-section, are unavailable. The objective of this study was to determine whether or not colostrum replacement or supplementation with a commercially available product could increase serum IgG concentrations in beef calves delivered by elective C-section, compared to beef calves that nursed colostrum naturally. An elective C-section was performed in 32 pregnant beef cows and first-calf heifers. Immediately after delivery, newborn calves were randomly assigned to one of three different treatment groups. Group A calves (n = 7) were fed one packet of a commercial colostrum replacer (CR) product providing 60 g of IgG within 30 min of life. A second packet of the same CR was fed at 6 h of life. Group B calves (n = 13) were fed the same CR at the same frequency as group A; however, these calves were reunited with their dams after the second CR feeding to allow additional nursing of maternal colostrum. Group C calves (n = 12) were united with their dams immediately after surgery without colostrum intervention. Serum IgG levels at 48 h of life were greater in group C calves and in calves born to multiparous cows. Based on the results of this study, neither colostrum replacement nor supplementation result in higher serum IgG concentrations in beef calves delivered by elective C-section compared with natural nursing.

Undisturbed home cage recording of mouse activity and behavior has received increasing attention in recent years. In parallel, several technologies have been developed in a bid to automate data collection and interpretation. Thanks to these expanding technologies, massive datasets can be recorded and saved in the long term, providing a wealth of information concerning animal wellbeing, clinical status, baseline activity, and subsequent deviations in case of experimental interventions. Such large datasets can also serve as a long-term reservoir of scientific data that can be reanalyzed and repurposed upon need. In this review, we present how the impact of Big Data deriving from home cage monitoring (HCM) data acquisition, particularly through Digital Ventilated Cages (DVCs), can support the application of the 3Rs by enhancing Refinement, Reduction, and even Replacement of research in animals.